1. Summary. There are 14 human cases confirmed by local testing, so far, but no new deaths. There is still no evidence of human-to-human transmission. The geographic distribution of the confirmed cases has broadened to central Anatolia. 17 provinces have had outbreaks in birds with animal quarantines in effect and proactive culling, including 130,000 birds in eastern Turkey. End Summary.
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Cases in Humans
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2. As of mid-day January 9, a Ministry of Health (MOH) official confirmed to us there are is a cumulative total of fourteen human cases that have tested positive locally for H5N1 in Turkey. So far only four of these have been confirmed by testing in London, however, local medical experts believe the London laboratory will confirm the local results. There have been no new deaths and the MOH said there continues to be no evidence of human-to-human transmission.

3. The geographic distribution of the confirmed human cases has broadening substantially to include areas around Ankara (in the center of the country) as well as the northern Black Sea areas. According to MOH, the five newest cases (out of the fourteen) include one from Van, two from Kastamonu (hospitalized in Ankara), one from Corum (hospitalized in Ankara) and one from Samsun (hospitalized in Samsun). Kastamonu, Corum and Samsun all lie in north central Anatolia, between Ankara and the Black Sea, and are hundreds of kilometers away from the previously-confirmed human cases in Van and Erzurum in far eastern Turkey.
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More Cases of Animal Infections
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4. The incidents of AI in animals are quickly spreading across most of Turkey. Ministry of Agriculture (MARA) officials indicated that suspected cases of AI have now been found in 17 provinces. The affected provinces are grouped in the eastern, central and north western part of Turkey as well as one southern province (Sanliurfa). In some cases there have been multiple outbreaks in individual provinces. The Ministry has taken a proactive position on the outbreaks setting up quarantine zones from 3 - 10 km, depending on the area. A private sector poultry representative noted that the GOT was somewhat slow in reacting to the outbreaks in eastern Turkey compared with the first outbreak in the

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October in the Marmara region (western Turkey) because there are no commercial operations in eastern Turkey. During the first outbreak the private sector played a key role in responding to that outbreak.

5. The Ministry of Agriculture is taking a proactive role in culling birds. Over 130,000 birds have already been culled in eastern provinces. The government's policy will be to completely cull all birds in this region. In addition, they will cull birds in quarantined areas (up to 3 km) in other provinces. The central government has now allocated 33 million YTL (about $24 million) for compensating farmers for culled birds (up from 7 million as of January 6). In addition, local governors have undisclosed funds available for this purpose. One official noted that procedures for distributing the central government money have not yet been finalized resulting in a delay in compensation.
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International Actions
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6. Press is reporting that Iran has closed the Hakkari border crossing with Turkey. The European Commission announced that it is banning importation of untreated feathers, not only from Turkey, but also from Azerbaijan, Armenia, Georgia, Syria, Iran and Iraq and reiterated the EU's complete ban on the importation of live birds and poultry products from Turkey, which was adopted in October, 2005. Press reports that the Chief Epidemiologist in Russia has urged Russians to avoid travel to Turkey, especially eastern Turkey.

7. Appearing on television with a Turkish minister, a WHO official praised Turkish authorities for their transparency and good cooperation between the two lead ministries.
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Assistance
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8. The Under Secretary of the Turkish Ministry of Agriculture provided us the list of requested items which the GOT is requesting from the World Bank. These items fall into three categories, which are protective gear, training, and incineration equipment. Post is faxing to USAID and State Turkey desk. To date the Turkish Government has not made an explicit request of assistance to us,however, we reiterate our previous request that Washington agencies assess their capacity to response to Turkey's critical needs so that the U.S. Government can join with other international organizations in dealing with this urgent and

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growing problem.
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Local Practice
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9. Government and IO efforts to address the outbreaks are being hindered by a number of local practices and indigenous factors. Because of extreme cold in parts of the country, many back-yard poultry farmers have taken their birds inside their homes. Moreover, most of these impoverished families are accustomed to slaughtering and eating sick birds - regardless of the cause of illness. Most of the government's public outreach efforts have been complicated by the fact that the rural populations in eastern Turkey are primarily Kurdish speakers and many of these are illiterate. McEldowney